There are many causes of cough including upper respiratory infections, asthma, allergies leading to post-nasal drip, pneumonia and pollution. However, another cause of cough that often is not diagnosed by physicians is habit! Cough that is caused by habit typically starts because of an infection, but once the infection resolves, the cough remains as a result of a habit. Such a cough can persist for months or even years. The cough can occur as frequently as every couple of seconds, but sometimes as infrequently as a few times an hour. Other names of habit cough include psychogenic cough, cough tic, and somatic cough syndrome.
Clues that a cough might be caused by a habit include that it almost always stops when a patient falls asleep, and often improves when a patient is distracted, such as by a video game. Habit cough can tend to be loud, disruptive, and sometimes even honking. In children, habit cough often is associated with missed school and stomachaches.
Like other medical symptoms such as headaches and stomachaches, habit cough sometimes is worsened by psychological stressors in a child’s life such as academic difficulties at school, bullying, or distress within the family such as related to divorce of the parents or the death of a loved family member or pet.
Medications do not help improve habit cough because there is no physical cause that is triggering it. However, since many doctors are slow to recognize habit cough, children often are treated with medications for asthma, allergies, acid reflux, and/or tic disorders with no improvement, before a diagnosis is made. Treatments that do work for habit cough include wrapping a bed sheet around the abdomen and tightening it each time that the patient feels that he or she might need to cough, suggestion therapy, in which patients are told repeatedly that they can control the cough, and hypnosis.
Children who have developed a habit cough often describe a tickle in their throat that they cannot control and that causes them to cough. I explain to them that when they cough, they further irritate their throat, which is how a cycle of coughing can continue. The key to learning how to control the cough is to be able to ignore the tickle.
Hypnosis can help with ignoring the need to cough by teaching children how to calm themselves, imagine turning down a dial that controls the cough, or figuring out whether a stressful issue might be contributing to the cough prolongation and how to better deal with the issue. With hypnosis, habit cough can resolve within a single session half of the time, and within a month for most patients.
Cough that results from an illness that causes spitting out of mucus (such as asthma or pneumonia) should not be treated with hypnosis with the purpose of reducing the cough because such coughing helps clear the body of secretions that otherwise could prove damaging to the lungs.
As hypnosis is very effective in the treatment of habit cough, this therapy should be considered early in the therapeutic plan for any child with chronic cough that does not improve with medical therapy.
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